Chapter 3. Practicing Nursing Knowledge
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57 By 1931, supporters of the new Nursing Service had a consistent message that it sent to the Rockefeller Foundation in support of its practice and teaching missions. Grace Anderson, in her report to the Foundation on the work of its Teaching Service, spoke directly to its significant success in “pooling of professional knowledge and skills in working out the essentials of a family health program for the community.” Only in East Harlem—­ and, she argued, nowhere else in the country—­ could observation and practice be directly correlated with theoretical instruction in education, psychology, sociology, nutrition, mental hygiene, and social casework. Its students from around the globe learned about family relationships in class and focused on improving them in practice. It provided its students with a “social laboratory” in which experiences were translated into new principles and practices.1 And rather than reporting their prenatal and health work with mothers, infants, and children as separate categories , Anderson spoke more directly to their work with families as a whole. Homer Folks also carried a similar message to the Foundation. As he wrote Thomas B. Appleget, the Foundation vice president to whom the Service now reported, it was now a successful “family service.” Its success lay in its specific recognition “that public health nursing is a complex undertaking which must derive many of its techniques from specialists in other fields.” The teaching and supervisory staff at the Service now included nutritionists, mental hygiene specialists, social workers, teachers, and physicians. Mindful of the Foundation ’s concern about where and how a public health nurse should be educated, he also noted the strategic position of a fully trained nurse. Through calls from mothers seeking prenatal care for themselves or home nursing for sick Practicing Nursing Knowledge Chapter 3 58 Nursing with a Message children, such a nurse reached “a cross-­ section of the community—­ families that would not be known to other agencies.”2 He reemphasized this in 1932, calling attention to the increasing interdisciplinary nature of the family service . “The Nursing and Health Service has disregarded the barriers that exist between professional groups,” he wrote, “and has brought experts in nutrition work, in mental hygiene, in social work, and in education into a close working relationship with nurses and physicians to the end that a more complete service may be rendered to the people of the community.”3 On one level, this chapter explores the knowledge needed for this reworked notion of public health nursing practice. Some, such as the knowledge required for generalized public health nursing practice, had long fallen within nursing’s domain. Other kinds involved knowledge relocations as messages about health and illness became more normalized and standardized. Supported by additional funding from the Milbank Memorial Fund, for example, the Bellevue-­ Yorkville Demonstration Project charged two public health nurses with developing health education curricular materials that the city’s public and parochial school teachers would incorporate into their own lesson plans, freeing up time for these schools’ own nurses to incorporate vision tests, formerly the purview of physicians, into their own practices. And still others involved incorporating new knowledge, particularly that associated with the mental hygiene movement, into extant disciplinary practices. But this chapter is about more than the knowledge required for health work. It is also about how ideas about health circulated between and among constituents, how they were implemented, and how their implementation fed back into new policies and practices. At the Bellevue-­ Yorkville Demonstration Project, for example, the relationships were fairly straightforward. In conjunction with the Department of Health, it had also prioritized health initiatives, particularly those promoting the periodic medical exams. It hoped its medically rich environment would provide the support and the resources necessary for this campaign. The Bellevue-­ Yorkville Project fought hard: It invited local private practitioners to the center to learn about and practice this new medical procedure; it sent nurses into their offices to educate their patients; and it offered laboratory services for specimen analyses that were part of a comprehensive health exam. The Project, however, failed: Physicians remained skeptical about a practice for which they had received no training in medical school; and patients remained suspicious that this was just another way for physicians to extort more fees.4 At the East Harlem Nursing and Health Service, however, the relationships were more complicated. These nurses, like other progressive urban colleagues Practicing Nursing Knowledge 59 throughout the country, used their practice experiences to move to legitimizing their claims to families as their...

Subject Headings

  • Community health nursing -- New York (State) -- New York.
  • Public health nursing -- New York (State) -- New York.
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